My toddler doesn't like to get his teeth brushed. How do I get him to be more cooperative?

He knows it's part of the bedtime routine and doesn't try to avoid it. He will happily grab and hold out his toothbrush for us to put toothpaste on it, and then he enjoys sucking and chewing it.

When he's done that for a short while, we decide it's necessary to do it properly, and that often ends in me holding him while my wife brushing his teeth, while we explain what we're doing and why. It only takes 20 seconds, but it's always accompanied by screaming and squirming. I'd like to find a way to avoid this. As soon as we're done, everything is fine again.

Clarification and update:
At this age, we don't expect him to be able to brush his teeth on his own. What I meant was that he didn't allow us to do it for him either.

In the meantime, four months have passed since I asked this, and he's developed a lot. Now he gladly lets us brush his teeth carefully and cheerfully.

Update 2:
Another 6 months have passed, and he's still not enjoying the experience. He understands that it has to be done, and he sees us do it too. Sometimes he'll happily let us brush his teeth, other times it's a struggle.

We are using several suggestions from the answers below -- we sing, we distract, we talk about "dirty teeth" and brushing the "dirty sugar" away, we let him brush on his own for a while and then take over, he can see himself in the mirror, etc.
All of this helps, but one factor certainly is that he's tired, and that's natural because brushing teeth is part of the bedtime routine.

I see. Well i guess then it's really only a thing he will grow out eventually. \o
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HannibalApr 5 '11 at 20:44

1

It's pretty common. My toddler does it too. Somehow, we've convinced him to let us do it; just practice and patience, I guess.
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ashes999Apr 7 '11 at 20:16

@ashes999 yep that's right. After several months of struggle, the tide suddenly turned and now it's fun and he happily lets us brush his teeth. But we have to be quick.
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Torben Gundtofte-BruunMay 6 '11 at 6:41

28 Answers
28

Our daughter displayed many of the same behaviors your cite and we had to resort to having one parent hold her while the other brushed her teeth properly. What we found helpful, though, was to have the parent brushing the teeth to say the vowels aloud - Aaaaaa, Eeeeeeeeee, Iiiiiiiiiii, Ooooooooooo, Uuuuuuuuuuu, and sometimes Yyyyyyyyyyyyyy - and to encourage her to say them.

After a few times, she lessened her resistance. Our thought was that she understood that when the vowels ended, the brushing would end, giving her a cue as to how long the session would last and how close it was to ending. It also gave her something to do. Not long after she started saying the vowel sounds, too, which further distracted her and made brushing easier for everyone involved.

Another thing to try is to have another parent brush his or her teeth at the same time. Let your son see that brushing teeth is something his parents do, as well. Children are naturally interested in imitating the behaviors of their parents.

If none of the above work, try compromising by letting your son brush his own teeth himself after you brush them. (This works particularly well if he's at that stage where he wants to do everything himself.) In short, you explain that you will brush his teeth - Aaaaaa, Eeeeeeeeee, Iiiiiiiiiii, Ooooooooooo, Uuuuuuuuuuu, and sometimes Yyyyyyyyyyyyyy - and afterwards he can hold the brush and brush them himself.

Sometimes some strange trick will work. Our son started to accept his teeth being brushed when he got to hold a hand mirror and watch it from there. He sometimes still asks for the mirror though he's mostly forgotten about it, but lets brush her teeth normally.

Great advice, the child can't see whats happening without the mirror and it should help to see that nothing scary is happening.
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BarfieldmvMay 4 '11 at 7:56

We do this, but we have my son brush in front of the wall mirror, he likes to see himself while he brushes and its less work for us to hold the mirror. sometimes I even engage in a contest to see who brushes the best, and we do it together.
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MichaelFMay 5 '11 at 16:28

First I would welcome them like my dentist does, "Hello Mr. G! My name is Dr. G. and I'll be your dentist today. Is there anything I need to know before we begin?" I was surprised at how often my kids had canker sores that I wouldn't have known about otherwise.

Then they would lie down in my lap (sometimes this was easier to do in bed) and I would count their teeth, just like the dentist, carefully brush each one, expressing great appreciation for how beautiful their teeth were and how much care they were taking of them.

This game was surprisingly popular with my two, with both being eager to be first. They really enjoyed the formality of being treated like an adult.

Both of ours went through a stage like this (in fact number two is still going through it).

Lighten up - if you don't get a perfect brush in EVERY day, nothing bad is going to happen

Make sure it really is about the teeth and not power struggles

Try a mixed approach - if one idea works for you, great, but have a whole load of others ready!

Making a game out of their resistance worked (sometimes) for me: I'd poke the brush at the, and they'd turn their mouth away, but every now and then (because they're laughing) I'd 'hit'. Generally, after a few minutes of that and them laughing silly, they'd relax and let me 'win' .. a bit. Sometimes.

Hehe. Yes, I'm sure that at some point in the past I've done the "Muahahaha! I'm going to get you!" game with our 4 year old. Now, he takes great pride in making all his teeth good and clean.
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ErnieJun 1 '11 at 19:59

Interesting toothbrush and other gear: we've tried half a dozen, and the electric one works the best. I think you have to be extra gentle though to make sure it doesn't hurt. I like user339's advice about trying a mouth mirror. Go shopping with your toddler to pick out his equipment.

Build on what he does understand: my mom taught my 20-month son to understand what's "dirty" (trash, diaper bin, etc) and he knows he should not touch dirty things. I recently told him his mouth was dirty if we didn't brush his teeth clean (complete with me smelling his mouth and making a stinky face). Amazingly, this worked best.

Model: as mentioned, model with yourself. Also liberally brush the teeth of his toys, bathtime duckies, etc.

Remember -- the screaming your kid does in your arms is much better than the screaming that would happen when they get cavities filled.

I'd also say that an electric brushing system will help him have more independence with brushing down the road. Sonicare has a brush that has a timer in it. Also make sure it is soft bristled.
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balanced mamaJul 11 '12 at 16:50

I mention this possibility first not because it's more likely (it's not) than the latter, but because you want to be at least reasonably sure that it is not the case before you push the issue. Children with moderate-to-severe oral sensory issues tend (in my experience) to develop phobias around oral care or trying new foods when these things are forced on them repeatedly without deference to the disorder.

Oral-sensory issues of various types are not uncommon in young children, especially children who also have autism-spectrum disorders, speech problems, or other sensory problems. Children with oral-sensory problems may experience overwhelming or confusing sensations from temperatures or textures they encounter orally (sometimes to the point of causing mindless panic).

If your child is also a very picky eater, and reacts particularly strongly against foods with mixed textures (for example, something that is both grainy and goopy), he may have an oral-sensory problem of some kind. The usual advice is to see a pediatrician about this, but in my experience an SLP (Speech-Language Pathologist) is usually more helpful, because the problem co-occurs with so many speech disorders that they deal with it more often than a typical pediatrician. If you are lucky enough to find one, there are dentists who specialize in helping children with oral-sensory issues care for their teeth.

Your child may simply not be accustomed to brushing properly.

Brushing takes some getting used to -- it's a funny feeling, and may even be painful if not done regularly, because the gums aren't accustomed to it. Add to that the harsh scratchiness of chewed-up toothbrush bristles, and it's a recipe for an unpleasant experience.

Here's what I'd recommend to try to fix things:

Buy a new, soft, child-sized toothbrush (go for a character, lights, or some other novelty if it helps your child get interested). Introduce it as his "big boy toothbrush" and DO NOT permit chewing on it.

Introduce the sensation of brushing in small spurts. Be extra gentle, and take it slow. You can increase to normal pressure and duration when he is more accustomed to the feeling. Find ways to make a game of it if you can, like taking turns (he brushes a little, then you brush), or brushing together to see who can brush the longest. Let him win after about a minute and a half (length of brushing my dentist recommended for young children).

Be consistent. Letting it go for a while, then trying again only adds to his resistance. A consistent routine, morning and night, will help you build momentum and make real brushing the rule rather than an exception.

Model good brushing -- brush with your child, and let him see that it's not a bad thing. :)

I didn't even know there's such a thing as oral-sensory issues. I'm fairly certain that's not the case because none of the indications you mention apply. In regard to your second suggestion: we've replaced the toothbrush quite often, and we're using soft baby toothbrushes. But it's good that you point it out. I think the way to go is more play -- that part of your answer is the most directly useful to us.
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Torben Gundtofte-BruunApr 5 '11 at 18:13

Our daughter was the same with the sucking and chewing but one trick we use that has worked really well is one parent brushing at the same time while the other parent is the 'judge' and seeing who can make the loudest noise while smiling and brushing up and down/ side to side,

Once it became a game with a bit of competition she happily stands there brushing for quite a while and 'making the noise' ensures she does it properly.

..also sometimes she likes to watch herself brushing her teeth in the mirror - if you have a big enough mirror then you can stand beside him so he can compare how you do it against how he does it; it's our fallback when the noise game fails.

The thing that in my experience helps the most is letting the child brush your teeth while you brush theirs. It makes brushing fun for the kid - might not be as fun for you as you try to cope, but a) it gives the child an active role instead of just standing around with open mouth; b) it shows trust; c) it makes the time pass more quickly for the child; d) it gives you a new perspective into just how difficult it is to stand agape while someone scrapes the insides of your mouth, which makes you a better, more patient and gentle brusher in the long run. For the more passive approach, telling a story about a girl/boy who didn't brush (and the consequences) is a tested method that works well. I'd also echo cabbey's sentiment about plain-chalk, non-flouridated toothpaste. Children's toothpastes are disgusting, sickeningly sweet and normal "adult" ones are too strong and minty. We use a "chalky" toothpaste with some herb essential oils, it's mild and doesn't leave a strong aftertaste.

In my opinion, distracting the child is a wrong approach. It reinforces brushing as a boring chore, and doesn't communicate how important it is and why. If brushing is something a child endures, they won't learn how to do it well and they'll hate having to do it later.

My toddler loves the toothbrush, but didn't want me to brush his teeth, just wanted to chew on it, until I tried letting him brush my teeth. We take turns though. First, he gets to brush mine, and then he usually lets me get his.
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RachelApr 5 '12 at 4:13

We have a toothbrushing song that I made up. It's a pretty stupid song, but he's small and doesn't care. I start the song as I brush his teeth and then stop sing at some point in the song and let him say the next word then start singing again. I do this a few times throughout the song. It keeps him engaged. Sometimes I'll even say the wrong word in the song and then we'll both laugh about it and say "No", and then I keep going. For us that worked really well. Like I said it's not a a great song by any stretch of the imagination, but two-year-olds don't really care.

We got the MOST effective improvement in our son's brushing habits by moving away from the "kids tooth paste" in bubble-gum-tooti-fruiti-cherry-so-sweet-you-wanna-puke flavor to just plain old non-flouridated baking soda tooth paste. He still wants to suck on it a little bit, and chews to some extent on the bristles, but that one change alone was like a night and day difference for him. He'd of course rather do it himself, but he doesn't seem to fight as much when we step in and help.

Lately I've been using Vic's modeling idea to great success. I prep his and my toothbrush at the same time (with the same toothpaste) then we sit across from each other face to face and brush together. I step through the various parts and he at least tries to do them. And it keeps him distracted from eating it!

Having your teeth brushed by someone else isn't nice. It's invasive. Realizing that much is a good start. The right brushes, being aware of when and where your child is teething and gentleness all help, but it's unlikely to ever be an entirely enjoyable process.

The usual combination of patience, consistency and self control comes into play too.

Getting around this normally boils down to finding some way "make it fun" - in some way that capture's your child's imagination. For us, we had a few different soft toys who would "brush" my daughter's teeth, and she would choose a different one each night.

That's an excellent idea! For what it's worth, I remember enjoying having my teeth brushed as a child and would often ask for it despite being able to do it myself.
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Torben Gundtofte-BruunJun 15 '12 at 8:22

And in keeping with childrens' general ability to make a liar out of anyone, the eldest, who is now 5, now asks to have her teeth brushed though she often does her own. I guess it's the attention.
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IanBruJul 29 '12 at 7:32

We used to have a chair just outside the bathroom and sung the 'kingdom of teeth song' when it was time for teeth brushing, basically a loudly renditioned da da da ta da of the lord of the rings theme song.

Following that I would tell a story about the kingdom of teeth making up something about a mythical land of teeth where the teeth where the entrance to the land and told stories of adventures of knights, princesses and random ducks on a pond.

After some unhappy struggles, mostly ending in him lying pinned in my lap while I forcibly brushed them :-( I realised it was too stressful for us both and so tried putting some toothpaste on his and my brushes, giving him my toothbrush to do my teeth whilst brushing his. It worked like magic. He is too busy brushing mine to complain and at the same time seeing exactly what I am doing to his teeth. I like the ideas about the mirror and the dentist game, I will try them if we get resistance again!

I'd go crazy too having someone brush my teeth. ;) I can only recommend to relax. Brush yours and let him find his way to do it. It will come if you can show him that you are convinced that he is capable of doing it properly. And as long as it does not, remember that it is your fear that lets him very little room to decide about his body. Don't force him into resignation. Let him explore and let him know it's his realm. And let him experience unbrushed tooth, too. This is where we take our motivation to brush ours! And it's not really that dangerous as we tend to think to go to bed without having your tooth brushed properly. The harm that can be done to the relationship between you and your child by forcing it is much worse than some potential hole in a tooth. Just imagine the respect he will experience when you ask him if he wants help and you would accept his no.

The other day on a familylab talk there was a mother telling about the big fights she has with her daughter because the daughter doesn't want to brush her teeth. The mother was asking for advice. Mathias Voelchert from familylab asked her if she could try to not care about her teeth for the next 14 days. It wouldn't be the end for her teeth but could be a beautiful 2 weeks for their relationship. :)

I have three children and each was a different experience in getting them to consistently brush their teeth. My oldest is 11 and unfortunately we were not very consistent with her as a youngster. She never wanted to brush her teeth. She brushes her teeth on her own now, but only because of what we did with the younger ones. My two youngest are 6 and 4. We made a conscious effort to display that both mom and dad brush their teeth every morning and night, and even after meals by making a big show of it while they were toddlers and barely had teeth. By the time they got a full set they were begging to do their own. As they got older we stayed consistent modeling the behavior and making it obvious. This in turn has helped my oldest also begin to make brushing at least twice a day a habit. My point: show your child(ren) the behavior you want them to have. Be consistent and have patience.

He likes that he is being "worked on". Sometimes he just doesn't want to brush and those nights I'm sorry to say we hold him tight and just do it for him. Oral health is important and it's a habit that takes a lot of pattern to keep.

The kid should already know that brushing his/her teeth before sleeptime is part of the drill. What we do is count down from a slowly increasing number (started with 10, 15 the next day currently we start at 100,90,80....25,24...3,2,1)

After the countdown our child could brush his own teeth for as long as he wanted too.

Brushing the front teeth when they exhale can make a funny, blu blu blu sound if you do it correctly which makes brushing the teeth more fun.

I was watching The Two Towers one day, while my daughter was watching a princess movie in the other room. She wandered in and started watching The Two Towers with me. There were some orcs on the screen, and it struck me. "Addison, see those guys? They're called orcs. See their teeth? They're yucky aren't they? That's what happens when you don't brush your teeth."

We haven't had too much of a problem since then, and she occasionally attempts to explain to her little brother that his teeth will look like an orc's if he doesn't let us brush them.

I try to use distraction techniques. My son tends not to mind the brushing if I occupy his attention with something else. At first I used short videos, but for a very long time now I've made up a story on the spot after asking him for a "topic." If I'm not feeling particularly creative, I'll try to recount our day or talk to him about some upcoming event he's excited about.

One trick that has worked for us is telling stories on thomas train. I brush his teeth while his dad tells the stories. It takes two stories for us to completely brush his teeth.
I also liked the mirror technique. i will keep that as plan B :P
One thing which used to work for us (he doesnt buy into it anymore now) was to let him brush my teeth (without toothpaste of course) while I brush his :D

When those first pearly whites emerge (or even before) begin using an Infadent brush. This soft sleeve with fine bristles fits over the tip of an adults finger. It is dense enough to protect from bites and feels good to gums. And, it comes with an "infant" toothpaste and is easily cleaned.

Then, graduate to a vibrating toothbrush. The vibration is of great benefit to ones with oral sensory sensitivities and makes toothbrushing fun.

Toothbrushing requires refined motor movements. Toddlers are just learning to move one hand across the midline of their body (the preceding developmental level is moving hands together at midline). Making refined short movements in a tiny space (the distance of the horizontal surface of a tooth) are difficult. They have just learned to hold a spoon and hitting their mouths (maybe). And making squiggly marks in a 1/2 inch space without getting "out of the lines" is not likely. Yet that's what we are basically asking of them.

Rotating their wrist up and down or laterally is equivalent to me doing a somersault. It is not going to happen with a pleasant outcome. If their movement is not smooth and refined the results are pushing too far causing a gag or poking tender tissue.

Add to this that moving their tongues for feeding is a new and unrefined skill. Do you ever have problems keeping your tongue away from where the dentist is working? And how long have you been practicing oral motor skills? They are more skilled at biting and sucking. That's what they have had the most experience doing.

No wonder they get frustrated and refuse to do a task that is so risky and difficult for them. My definition of toddler could be "independence seeker". Yes, it would be easier if you did the task for them, but goes against their "I'll do it myself" agenda at this age.

The strategies listed in this post are about motivating a child to keep trying. Being aware of the difficulty of the task of toothbrushing will help you understand his resistance and discover reinforcers that are worth his effort and discomfort and gain his cooperation.

I don't dispute your answer, but I didn't mean to ask how we can get him to brush his own teeth; we just let him play with the toothbrush a little, before we take over and do the actual brushing. At 1½ years of age, we don't expect him to be able to do it on his own.
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Torben Gundtofte-BruunJul 30 '11 at 19:42

My sister is a dentist, so she gave a cute toothbrush with lights on it. When my son saw it, he was too excited to use it, and he keeps on playing with it, while I was helping him to brush his teeth. Then I also bought fruit flavored toothpaste, so he would enjoy his toothbrush experience. If doesn't like to brush his teeth, I don't force him, but I am trying my best to train him to develop his brushing routine. It will really takes time and patience to teach children. Anyhow, I believe that when grows older, he will be able to realized the importance of brushing his teeth. For the meantime, that he doesn't know yet, I have to patiently wait for the moment when he is on the mood to brush, or I make up stories to encourage him.

I just posted this on another answer (more to do with when rather than how) but my answer does explain how we did it.

We started this as soon as he had a few teeth (round about 12 months) and found it easier to make it fun,

Essentially one of either my wife and I clean our teeth with him, we clean his teeth then let him hold the brush and "attempt" to clean his own too (he hasn't quite got the hang of this bit at 16 months :) )

Once done we ask him to let us smell his breath, this is the bit he really likes as he breathes on our noses and we exclaim how nice it smells, in fact he insists everyone in the apartment smells his breath!

Try using a towel or cloth to wipe his teeth off (outside, inside, and tops), and then floss. Some children don't like the feel of the tooth brush, and some have a hard time controlling it smoothly. A towel is more direct-- hands on-- and it may be easier to do a thorough cleaning with a cloth. Also, if you're trying to clean the teeth of a struggling child, there's less risk of injury to the child with a towel.

This is what my hygienist recommends for infants (minus the flossing). Can you provide any elaboration on how this is more helpful than just using a brush along with the many ideas already offered?
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balanced mamaDec 4 '12 at 2:20

I can see how the towel idea could work. But a towel wouldn't be able to get to the small areas between the teeth. I guess that's why you suggest flossing, but then there's a new challenge -- how do you floss a mouth that small? And junior will probably not stay still for that either!
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Torben Gundtofte-BruunDec 4 '12 at 9:03